World
Health Assembly Resolution removes commercial influences from infant
feeding programmes
After a
thorough debate and a 3-hour drafting session, a new strengthened
Resolution on Infant and Young Child Nutrition (WHA
55.25) was adopted at the World Health Assembly in Geneva on
Saturday 18th May.
38 countries
spoke in the debate, the large majority of speakers from the
developing world calling for the draft text to be strengthened to
ensure that the critical importance of exclusive breastfeeding for
the first six months was mentioned and that infant feeding
programmes do not involve the baby feeding industry (beyond the
requirement to respect the International
Code and subsequent relevant WHA Resolutions).
The
Resolution endorses a new Global Strategy for Infant and Young
Child Feeding, the outcome of a four-year consultative process
involving all member states.
One issue
that raised consciousness of the need to do more to protect
breastfeeding in all countries, not just in developing countries,
was the case of the 5 day old Belgian baby, who died of meningitis
in March after being fed Nestlé Beba 1 dried infant formula
from a batch which was contaminated with Enterobacter
Sakazakii. As a 'precautionary measure' on April 22, Nestlé
blocked sales of the affected batches of Beba 1 in Belgium
and Luxembourg. It has not done so in Switzerland where the product
is also sold. Nestlé maintains that current manufacturing processes
are not sufficient to remove the contamination, indicating that the
problem may be widespread. A search in Medline reveals many more
cases of enterobacter sakazakii infections due to contamination of
infant formula in the past years. IBFAN is calling for more to be
done to warn the public about the risks of artificial feeding. (see
IBFAN
Press Release 10 May 2002)
Two new
monitoring reports from the USA and Canada launched in Geneva at the
time of the World Health Assembly also highlighted the flagrant
violations of the International Code in industrialised
countries and the failure to protect mothers' rights to make fully
informed decisions about infant feeding. (Click
here for IBFAN's intervention on infant and young child
feeding).
During the
Assembly debate on the draft resolution notable interventions were
made by several countries: The Indian delegation called for the
removal of the term 'commercial' saying:
"Commercial enterprises by
definition are profit driven entities. It is neither appropriate
nor realistic for the WHO to expect that commercial groups will
work along with governments and other groups to protect, promote
and support breastfeeding."
India also
drew attention to WHA
Resolution 49.15 which in 1996 urged member states to ensure
that monitoring is carried out in a transparent independent manner,
free from commercial influence and that financial support for
professionals working in infant and young child health does not
create conflict of interest.
These
concerns were reinforced by a number of countries including Palau
which appealed to WHO to "protect Member States from undue and
unwanted influence by industries and manipulation by them".
In addition
to the intervention on the infant feeding debate, IBFAN and
Consumers International made an intervention on the report on Diet,
Nutrition and Physical Activity (click
here for text). IBFAN supported the opening address by the
Director General Dr Gro Harlem Brundtland, in which she laid down a
clear challenge to the trillion dollar food industry, referring to
WHO's intention to "reinvigorate WHO's work on diet, food safety
and human nutrition," and the problem of "excessive
consumption of fatty, sugary and salty foods". Dr Brundtland
said that:
"Getting loyalty
to brand names is the key to influencing consumer behaviour - from
the time children start to walk. Children currently influence 45%
of household purchases in the US, and 65% in urban China.....Brand
name promotions - whether for tobacco, alcohol or fast foods - are
designed to take advantage of peoples subconscious....... There is
certainly a need for guidance: in some cases, like tobacco
advertising and alcohol advertising aimed at the young, what we
need is control. WHO will play its
part."
IBFAN warmly
welcomed this new initiative but also expressed caution about the
increasing trend towards Public Private Partnerships. These concerns
were shared by the People's Health Movement and many NGOs such as,
Infact and Health Action International. IBFAN called for an urgent
review and change in WHO’s checking procedures and guidelines on
conflict of interest . Earlier in the infant feeding debate, several
Member States had expressed concern about the new UN/Bill Gates
backed Global Alliance for Improved Nutrition (GAIN) launched on 9th
May. GAIN - ironically the name of an infant formula - involves
companies known for pushing unhealthy brands of foods. The companies
include Procter and Gamble, Kraft, (a subsidiary of Philip Morris,
the tobacco giant) and Heinz a company well known for its violations
of the baby food Code. WHO has in the past clearly indicated that it
does not want to be involved in any 'partnership' or 'interaction'
with the tobacco industry or any of its subsidiaries, but its
guidelines on conflicts of interest are only in draft stage and are
unclear. UNICEF by joining this initiative is also violating its own
guidelines on the interaction with the private sector which exclude
the tobacco as well as violators of International Code.
An article
in the Wall St Journal on 9th of May, stated that the companies
involved in GAIN expect the UN system to intervene on their behalf
to lobby for favourable tariffs and tax rates and a speedier
regulatory review of new products in targeted countries. WHO staff
denied that such promises had been made, but failed to give
assurances about whether they would be involved in this
venture.
In his
answer on the Nutrition debate Dr Derek Yach, Executive Director, of
WHO's Non-communicable Diseases and Mental Health Cluster, said that
this issue needs to be addressed from a life course perspective,
including infant and young child nutrition. He went on to note:
"the concern of Consumers International with regard to the
possible adverse commercial influences on WHO's policy. And we
certainly can assure you that as Dr Brundtland emphasised in her
opening address, that we have a commitment to strengthen our
protection of conflict and perceived conflict of interest. "
WHO was also
asked for an affirmation that initiatives such as GAIN would not be
used to undermine breastfeeding or the progress made on banning
health claims on foods for infants and young children. At the Codex
Alimentarius labelling meeting in Halifax, Nova Scotia, the week
before the Assembly, this moved one step further. IBFAN stressed
that fortified junk foods would not be the answer to malnutrition
and called for WHO to conduct independent research into the impact
of marketing on the very poor.
Resolution
WHA 55.19 (click
here for a pdf file) was also adopted, calling for more action
to implement the development goals set out in the Millenium
Declaration. Breastfeeding is included as an important strategy in
achieving the development goals of the United Nations Millennium
Declaration adopted by the UN in September 2000. The Millennium
Declaration sets out to reduce maternal mortality by three-quarters
and under-five mortality by two-thirds by the year 2015. In order to
facilitate the achievement of these goals Member States are urged to
"continue to advocate as public health prioritites for safe
pregnancy and childbirth, breastfeeding and neonate, child and
adolescent health and development".
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